Overcoming Barriers to Cancer Pain Management: An Institutional Change Model

Virginia Chih Yi Sun, Tami Borneman, Betty Ferrell, Barbara Piper, Marianna Koczywas, Kyong Choi

Research output: Contribution to journalArticle

Abstract

The Agency for Health Care Policy and Research Pain Guidelines of 1994 recognized pain as a critical symptom that impacts quality of life (QOL). The barriers to optimum pain relief were classified into three categories: patient, professional, and system barriers. A prospective, longitudinal clinical trial is underway to test the effects of the "Passport to Comfort" innovative intervention on pain and fatigue management. This article reports on preintervention findings related to barriers to pain management. Cancer patients with a diagnosis of breast, lung, colon, or prostate cancer who reported a pain rating of ≥4 were accrued. Subjects completed questionnaires to assess subjective ratings of overall QOL, barriers to pain management, and pain knowledge at baseline and at one- and three-month evaluations. A chart audit was conducted at one month to document objective data related to pain management. The majority of subjects had moderate (4-6 on a 0-10 numeric rating scale) pain at the time of accrual. Patient barriers to pain management existed in attitudes and knowledge regarding addiction, tolerance, and not being able to control pain. Subjects who were currently receiving chemotherapy were reluctant to communicate their pain with health care professionals. Professional and system barriers were focused around screening, documentation, reassessment, and follow-up of pain. Lack of referrals to supportive care services for patients was also noted. Several well-described patient, professional, and system barriers continue to hinder efforts to provide optimal pain relief. Phase II of this initiative will attempt to eliminate these barriers using the "Passport" intervention to manage cancer pain.

Original languageEnglish (US)
Pages (from-to)359-369
Number of pages11
JournalJournal of Pain and Symptom Management
Volume34
Issue number4
DOIs
StatePublished - Oct 1 2007
Externally publishedYes

Fingerprint

Pain Management
Pain
United States Agency for Healthcare Research and Quality
Quality of Life
Cancer Pain
Documentation
Colonic Neoplasms
Fatigue
Lung Neoplasms
Prostatic Neoplasms
Patient Care
Breast
Referral and Consultation
Clinical Trials
Guidelines
Delivery of Health Care
Drug Therapy

Keywords

  • barriers
  • Pain
  • QOL
  • quality of life

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Neurology
  • Nursing(all)

Cite this

Overcoming Barriers to Cancer Pain Management : An Institutional Change Model. / Sun, Virginia Chih Yi; Borneman, Tami; Ferrell, Betty; Piper, Barbara; Koczywas, Marianna; Choi, Kyong.

In: Journal of Pain and Symptom Management, Vol. 34, No. 4, 01.10.2007, p. 359-369.

Research output: Contribution to journalArticle

Sun, Virginia Chih Yi ; Borneman, Tami ; Ferrell, Betty ; Piper, Barbara ; Koczywas, Marianna ; Choi, Kyong. / Overcoming Barriers to Cancer Pain Management : An Institutional Change Model. In: Journal of Pain and Symptom Management. 2007 ; Vol. 34, No. 4. pp. 359-369.
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